United States District Court, D. Minnesota
April A. Blair, Plaintiff,
Nancy A. Berryhill, Acting Commissioner of Social Security, Defendant.
E. RAU UNITED STATES MAGISTRATE JUDGE
to 42 U.S.C. § 405(g), Plaintiff April A. Blair
(“Blair”) seeks review of the Acting Commissioner
of Social Security's (“Commissioner”) denial
of her application for social security income
(“SSI”) and disability insurance benefits
(“DIB”). See (Compl.) [Doc. No. 1]. The
parties filed cross-motions for summary judgement. (Pl.'s
Mot. for Summ. J.) [Doc. No. 17]; (Def.'s Mot. for Summ.
J.) [Doc. No. 21]. For the reasons set forth below, the Court
denies Blair's Motion for Summary Judgement and grants
the Commissioner's Motion for Summary Judgement.
protectively filed for SSI and DIB on January 30, 2014,
citing an alleged onset date (“AOD”) of June 12,
2012, which was later amended to October 12, 2012. (Admin.
R.) [Doc. No. 11 at 10]. Blair claimed disability due to
fibromyalgia, stroke, aneurysms, carpal tunnel syndrome,
chronic headaches, joint pain, short-term memory loss,
depression, and anxiety. (Id. at 241). Blair's
claim was denied initially and upon reconsideration.
(Id. at 10). Following a hearing, the administrative
law judge (the “ALJ”) denied benefits to Blair on
May 9, 2016. See (id. at 7-28). The Appeals
Council denied Blair's request for review, rendering the
ALJ's decision final. (Id. at 1-3); see
also 20 C.F.R. § 404.981. Blair initiated the instant
law suit on October 4, 2017. (Compl.).
time of her AOD, Blair was thirty-eight years old which makes
her a younger individual. (Admin. R. at 26); see
also 20 C.F.R. § 404.1563. Blair completed high
school and has a cosmetology license and experience as a
cashier, dietary aide, cosmetics salesperson, collection
clerk, charge-account clerk, survey worker, cosmetologist,
and pizza maker. See, e.g., (Admin. R. at 211-231,
hearing, Blair testified as follows. Blair takes care of her
three-year-old son and lives with her twenty-two-year-old
daughter. (Id. at 41, 43). Blair last worked in a
kitchen for a nursing home with employment ending February of
2015. (Id. at 42) She would show up on time for her
scheduled hours, but would go home if she could not work
through her headaches (Id.). Blair testified that
she terminated her employment with the nursing home because
the time constraints to complete her work were too stressful.
(Id. at 42, 46-47). Further, Blair testified that
she has not sought new employment because of the
unpredictability of her headaches which occur three to four
times a week and typically last a minimum of six hours.
(Id. at 43).
Medical Evidence 
was admitted to the hospital on June 12, 2012, for an
induction of labor, and while in labor underwent a cesarean
procedure because of complications. (Id. at 496).
Blair complained of a severe headache and had difficulty
speaking during the procedure. (Id.). After the
procedure, a CT scan of Blair's head showed a hemorrhage
in the left temporal lobe. (Id.). Blair had
expressive aphasia throughout her hospital stay, and received
physical therapy and occupational therapy until she was
discharged on June 24, 2012. (Id.). Blair also had
issues with speech, memory, comprehension, headaches,
attention, and a decline in intellect as a result of the
brain hemorrhage secondary to an aneurysm. See,
e.g., (id. at 1481-86). Blair had continued
issues with slowed speech with hesitation and difficulties
with word retrieval. See, e.g., (id. at
566-567, 667-703). Blair continued with speech therapy and
made improvements by comprehending more complex material.
(Id. at 728-729). On December 18, 2012, Blair was
discharged from speech therapy because her speech therapist,
Linda Tyler (“Tyler”), believed Blair had
achieved her maximum benefit. (Id. at 908).
Specifically, Tyler noted Blair could actively participate at
the conversational level with occasional hesitancy and
minimal pauses for word retrieval. (Id.). Blair
experiences severe headaches affecting her on a daily basis,
and the headaches have become more intense with a pain rating
ranging from three out of ten to eight out of ten.
(Id. at 1026, 1076, 1482). Blair also suffers from
impaired memory that has become worse after the AOD.
(Id. at 1482, 1484-85, 1992).
is Blair's therapist at Southwestern Mental Health Center
and has seen Blair weekly since May, 2015. (Id. at
49, 51). Tingle testified before the ALJ stating that Blair
suffers from side effects as a result of her brain injury.
(Id. at 50-51). Tingle testified that Blair has
memory loss in different areas including short-term memory
and when stressed she will miss appointments if she is not
reminded. (Id. at 52-53). Tingle testified that when
Blair has a migraine it becomes very difficult to function
and that Blair's ability to interact with others is
unpredictable and varies from day to day. (Id. at
51-53). Tingle stated that Blair is unsuited for work and has
difficulty in her life due to cognitive impairment which
includes difficulty remembering the focus of conversations
and often requiring redirection to the topic of the
conversation. (Id. at 1524-1525, 2460). Tingle
reported that Blair has migraines three to four days a week
and is unable to function with a migraine. (Id. at
Dr. Michael J. McGrath
McGrath conducted a two-day neuropsychological evaluation of
Blair on December 4, 2014, and December 9, 2014.
(Id. at 1481-86). Dr. McGrath observed from a
personal evaluation that Blair was of dullish-normal
intellect, was responsive to interview questions, and spoke
clearly. (Id. at 1481). Dr. McGrath also observed
that Blair has concentration and memory issues, but can
operate a motor vehicle without spatial confusion.
(Id. at 1482). Blair obtained an intelligence
quotient (“IQ”) score of 71, which is a
score in the third percentile and lower than her estimated
pre-hemorrhage IQ of 85. (Id. at 1483). The drop in
fourteen points between the scores showed a clinically
meaningful decline in intellect. (Id.). Dr. McGrath
also observed that Blair's memory falls within the
“mildly mentally retarded range, ” but Dr.
McGrath stated that Blair's memory may be underestimated
because she is unable to process information quickly.
(Id. at 1484). Dr. McGrath observed that Blair's
auditory attention is in the “mildly mentally retarded
range” which scored in the second percentile and her
visual attention scored within the 0.1 percentile.
(Id. at 1484). Because of these problems Dr. McGrath
opined that Blair needs to avoid situations requiring
concentration and attention. (Id.). Blair's
auditory memory was found to be in the “mildly mentally
retarded range' at the 0.1 percentile and visual memory
in the first percentile indicating that she has very marked
memory impairment. (Id. at 1485). Dr. McGrath opined
that “it would be important to communicate fairly
simply in terms of both vocabulary and grammar, ” that
information input to Blair should be slowed, and that Blair
likely retains the capacity to do routine and repetitive
work. (Id. at 1485-86). Dr. McGrath suggested that
it would be psychologically beneficial for her to continue
with at least some part-time employment. (Id. at
Dr. Thomas Bergquist
Bergquist evaluated Blair at the Mayo Clinic. (Id.
at 1564-67, 2354-55, 2364-67). Dr. Bergquist observed that
Blair continues to have severe cognitive dysfunction and her
ability to make complex decisions, especially medical and
legal decisions, is somewhat questionable. (Id. at
2366). Blair obtained a score of 14 on the Patient Health
Questionnaire (“PHQ-9”) and a score of 20 on
the Generalized Anxiety Disorder survey
(“GAD-7”), which according to Bergquist, was
quite elevated. (Id. 2354). Despite these scores,
however, Dr. Bergquist opined that there was no indication
that Blair had a desire to harm herself or to harm others.
(Id. at 2355). Dr. Bergquist further opined that
Blair would benefit from the help of her mother and other
supportive individuals to overcome her functional
disabilities. (Id. at 2367).
State agency psychological consultant
reconsideration, the State consultant examined the medical
evidence and opined on February 2, 2015, that Blair was not
disabled. (Id. at 82-99). The State consultant
suggested that Blair's impairments could be expected to
produce some of the symptoms, but the alleged intensity of
the symptoms and how they affect Blair's functioning is
inconsistent with the totality of the medical evidence.
(Id. at 90). The State consultant opined that Dr.
McGrath's medical findings should be given great weight
because the findings explained the discrepancies in
Blair's tests scores and her ability to perform simple
day-to-day tasks. (Id. at 92). The State consultant
further opined that Blair's ability to perform day-to-day
activities, despite her mental impairments, should be given
greater weight. (Id.) The State consultant also
suggested that Blair's reports are only partially
credible because of the inconsistency of symptoms in her
reports. (Id.). The State consultant found that
Blair has memory ...